Language:

Investigation of a COVID-19 outbreak in Germany resulting from a single travel-associated primary case: a case series

The Lancet Infectious Diseases, 2020-08, Vol.20 (8), p.920-928 [Peer Reviewed Journal]

2020 Elsevier Ltd ;Copyright © 2020 Elsevier Ltd. All rights reserved. ;2020. Not withstanding the ProQuest Terms and Conditions, you may use this content in accordance with the associated terms available at https://www.elsevier.com/legal/elsevier-website-terms-and-conditions ;2020. Elsevier Ltd ;2020 Elsevier Ltd. All rights reserved. 2020 Elsevier Ltd ;ISSN: 1473-3099 ;EISSN: 1474-4457 ;DOI: 10.1016/S1473-3099(20)30314-5 ;PMID: 32422201

Digital Resources/Online E-Resources

Citations Cited by

Actions
1. Add to My Research
2. Remove from My Research
3. E-mail
4. Print
5. Permalink
6. Citation
7. EasyBib
8. EndNote
9. RefWorks
10. Delicious
11. Export RIS
12. Export BibTeX

Title:
Investigation of a COVID-19 outbreak in Germany resulting from a single travel-associated primary case: a case series
Author: Böhmer, Merle M ; Buchholz, Udo ; Corman, Victor M ; Hoch, Martin ; Katz, Katharina ; Marosevic, Durdica V ; Böhm, Stefanie ; Woudenberg, Tom ; Ackermann, Nikolaus ; Konrad, Regina ; Eberle, Ute ; Treis, Bianca ; Dangel, Alexandra ; Bengs, Katja ; Fingerle, Volker ; Berger, Anja ; Hörmansdorfer, Stefan ; Ippisch, Siegfried ; Wicklein, Bernd ; Grahl, Andreas ; Pörtner, Kirsten ; Muller, Nadine ; Zeitlmann, Nadine ; Boender, T Sonia ; Cai, Wei ; Reich, Andreas ; an der Heiden, Maria ; Rexroth, Ute ; Hamouda, Osamah ; Schneider, Julia ; Veith, Talitha ; Mühlemann, Barbara ; Wölfel, Roman ; Antwerpen, Markus ; Walter, Mathias ; Protzer, Ulrike ; Liebl, Bernhard ; Haas, Walter ; Sing, Andreas ; Drosten, Christian ; Zapf, Andreas
Subjects: Adolescent ; Adult ; Betacoronavirus - classification ; Betacoronavirus - genetics ; Betacoronavirus - isolation & purification ; Body fluids ; Child ; Child, Preschool ; China ; Communicable Diseases, Imported - epidemiology ; Communicable Diseases, Imported - pathology ; Communicable Diseases, Imported - transmission ; Communicable Diseases, Imported - virology ; Containment ; Coronavirus Infections - epidemiology ; Coronavirus Infections - transmission ; Coronaviruses ; Cough ; COVID-19 ; Disease Outbreaks ; Disease transmission ; Disease Transmission, Infectious ; Epidemics ; Epidemiology ; Fever ; Food safety ; Gene sequencing ; Genomes ; Germany - epidemiology ; Households ; Humans ; Incubation ; Infections ; Interviews as Topic ; Middle Aged ; Mutation ; Outbreaks ; Pandemics ; Patients ; Pneumonia, Viral - epidemiology ; Pneumonia, Viral - transmission ; Polymerase chain reaction ; Protective equipment ; Public health ; Quarantine ; Respiratory diseases ; Reverse Transcriptase Polymerase Chain Reaction ; Risk ; Risk Assessment ; RNA, Viral - genetics ; SARS-CoV-2 ; Secretions ; Severe acute respiratory syndrome ; Severe acute respiratory syndrome coronavirus 2 ; Signs and symptoms ; Testing laboratories ; Travel ; Travel-Related Illness ; Ultrasonic testing ; Viral diseases ; Whole genome sequencing ; Young Adult
Is Part Of: The Lancet Infectious Diseases, 2020-08, Vol.20 (8), p.920-928
Description: In December, 2019, the newly identified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China, causing COVID-19, a respiratory disease presenting with fever, cough, and often pneumonia. WHO has set the strategic objective to interrupt spread of SARS-CoV-2 worldwide. An outbreak in Bavaria, Germany, starting at the end of January, 2020, provided the opportunity to study transmission events, incubation period, and secondary attack rates. A case was defined as a person with SARS-CoV-2 infection confirmed by RT-PCR. Case interviews were done to describe timing of onset and nature of symptoms and to identify and classify contacts as high risk (had cumulative face-to-face contact with a confirmed case for ≥15 min, direct contact with secretions or body fluids of a patient with confirmed COVID-19, or, in the case of health-care workers, had worked within 2 m of a patient with confirmed COVID-19 without personal protective equipment) or low risk (all other contacts). High-risk contacts were ordered to stay at home in quarantine for 14 days and were actively followed up and monitored for symptoms, and low-risk contacts were tested upon self-reporting of symptoms. We defined fever and cough as specific symptoms, and defined a prodromal phase as the presence of non-specific symptoms for at least 1 day before the onset of specific symptoms. Whole genome sequencing was used to confirm epidemiological links and clarify transmission events where contact histories were ambiguous; integration with epidemiological data enabled precise reconstruction of exposure events and incubation periods. Secondary attack rates were calculated as the number of cases divided by the number of contacts, using Fisher's exact test for the 95% CIs. Patient 0 was a Chinese resident who visited Germany for professional reasons. 16 subsequent cases, often with mild and non-specific symptoms, emerged in four transmission generations. Signature mutations in the viral genome occurred upon foundation of generation 2, as well as in one case pertaining to generation 4. The median incubation period was 4·0 days (IQR 2·3–4·3) and the median serial interval was 4·0 days (3·0–5·0). Transmission events were likely to have occurred presymptomatically for one case (possibly five more), at the day of symptom onset for four cases (possibly five more), and the remainder after the day of symptom onset or unknown. One or two cases resulted from contact with a case during the prodromal phase. Secondary attack rates were 75·0% (95% CI 19·0–99·0; three of four people) among members of a household cluster in common isolation, 10·0% (1·2–32·0; two of 20) among household contacts only together until isolation of the patient, and 5·1% (2·6–8·9; 11 of 217) among non-household, high-risk contacts. Although patients in our study presented with predominately mild, non-specific symptoms, infectiousness before or on the day of symptom onset was substantial. Additionally, the incubation period was often very short and false-negative tests occurred. These results suggest that although the outbreak was controlled, successful long-term and global containment of COVID-19 could be difficult to achieve. All authors are employed and all expenses covered by governmental, federal state, or other publicly funded institutions.
Publisher: United States: Elsevier Ltd
Language: English
Identifier: ISSN: 1473-3099
EISSN: 1474-4457
DOI: 10.1016/S1473-3099(20)30314-5
PMID: 32422201
Source: Coronavirus Research Database

Back to results list


INSPIRE LIBRARY - TON DUC THANG UNIVERSITY	(84-028) 37 755 057	Feedback
19 Nguyen Huu Tho St. Dist.7, HCM	thuvien@tdtu.edu.vn	Feedback

Investigation of a COVID-19 outbreak in Germany resulting from a single travel-associated primary case: a case series

Searching Remote Databases, Please Wait